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Review Question - QID 106656

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QID 106656 (Type "106656" in App Search)
Two patients are vaccinated for poliomyelitis. Patient A receives the Sabin oral vaccine, and Patient B receives the Salk intramuscular vaccine. Six weeks after their initial vaccinations, which of the following would be the greatest difference regarding these two patients?

Patient A has a higher level of duodenal IgA antibodies

67%

376/563

Patient B has a higher level of duodenal IgA antibodies

5%

27/563

Patient A has a lower level of serum IgA antibodies

5%

26/563

Patient B has a lower level of serum IgM antibodies

6%

31/563

Patient A has a higher level of serum IgG antibodies

16%

91/563

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The Sabin vaccine is an oral, live-attenuated vaccine, whereas the Salk polio vaccine is an intramuscular (injected) inactivated vaccine. Vaccination with a live attenuated vaccine elicits a greater mucosal (duodenal and oropharyngeal) IgA antibody response in comparison to vaccination with inactivated (killed) vaccines.

Synthesis and secretion of localized antibodies is best when mucosal surfaces are directly stimulated by an antigen (in this case, the oral vaccination allows for contact of the antigen with both the oropharynx as well as the duodenum). In addition to the route of administration having a significant effect on immunity after vaccination, it has been shown that when both live-attenuated and inactivated vaccines are applied to a mucosal surface, the live-attenuated vaccine is more effective at inciting a mucosal IgA response. In the case of polio, the oral polio vaccine (OPV) offers improved mucosal IgA and immune protection at the normal site of viral entry, the gastrointestinal tract.

Incorrect Answers:
Answer 2: Intramuscular administration of a killed vaccine would lead to lower levels of mucosal IgA in comparison to patients who receive oral live-attenuated vaccines.
Answers 3,4,5: Serum IgA, IgM, and IgG levels would be expected to be affected roughly equally when comparing killed versus live-attenuated vaccines.

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